Options for Submitting Documentation - JA DME

• Hardcopy
• Fax
• Electronically by CD/DVD/USB
• Electronic Submission of Medical Documentation (esMD)
• Noridian Medicare Portal (NMP)

Hardcopy

To ensure Noridian receives and reviews hard copy documentation in an efficient manner, follow these guidelines. Failure to follow all of these may result in delay in processing.

• Place Noridian's letter, a request form or a coversheet on top of documentation for each claim
• If using a provider generated letter/form ensure the following items are included:
  • Facility name, contact and provider number
  • Patient's Medicare ID
  • Claim Control Number (CCN)
  • Dates of Service (DOS)
• When submitting multiple documents in the same envelope or package, ensure that each request is clearly identifiable to avoid unintentional merging of documents
• Do not submit binders of documentation
• Documents should be full sheets of standard-sized paper.
• Mail all documentation to the designated address indicated on our Mailing Addresses webpage.

Fax

To ensure Noridian is able to identify and accept faxed correspondence, the below requirements must be completed. Failure to follow all of these may result in delay in processing.

• To avoid unintentional merging of documents, submit separate faxes for each request.
  • Wait for first fax to be completely sent prior to sending another.
• Place Noridian's letter, a request form or a coversheet on top of documentation for each claim
• If using a provider generated letter/form ensure the following items are included:
  • Facility name, contact and provider number
  • Patient's Medicare ID
  • Internal Control Number (ICN)
  • Dates of Service (DOS)
• Fax all documentation to the designated number indicated on our Fax Numbers webpage.
• Claim submissions are NOT acceptable via fax.

Electronically by CD/DVD/USB

Noridian accepts records on CD, DVD or USB. Submitters must follow all requirements below. Failure to follow these requirements will result in the CD, DVD or USB being returned.

Image Content

• Image(s) must be submitted in PDF or multi-page TIF format
• Image(s) must include request form and supporting documentation
• Include request form as FIRST page on each file image

File Type & Organization

• All files must be placed in root location of CD/DVD/USB
• Applications or executables (.exe) will not be accepted
  • There shall not be any application or file extensions (i.e. .xml .exe, Dicom, and Roxio)
• Multiple requests may be submitted on same CD/DVD/USB; however, include each separate request in a separate PDF or TIF file. Files should be extractable without the need for editing or combining
• All documentation must be merged into one file; unless file size exceeds 100,000 KB
  • Files larger than 100,000 KB should be split. If more than one image is necessary, add a sequence to the file names
  • Request form must be included as first page on EACH file image
  • Folders should not be utilized
• All files should be for the same business department.
  • Do Not submit records intended for Medical Review on the same CD/DVD/USB as records submitted for Appeals
  • Do Not submit records for Part A and Part B on the same CD/DVD/USB
• For HIPPA and confidentiality purposes, name files with Patient Account Number or Medical Record Number (MRN) (e.g., MRN3470855.pdf/tiff or SH000565895.pdf/tiff)
  • If more than one image per request, indicate it is same claim documentation by adding a sequence to the file name (e.g., MRN3470855-1.pdf/tiff or SH000565895-1.pdf/tiff)

Password Protection

• Images should be password-protected
• Email password, mail tracking number (if applicable) and mailing date to nhspass@noridian.com
  • Do not mail or fax password
  • Do not include PHI information in email
  • Do not send email as a secure message that requires a password to access
• Noridian will only accept CD/DVD/USBs that are encrypted using Adobe Security, WinZip, 7-Zip or Secure Zip. Other formats will not be accepted, and CD/DVD/USB will be returned to provider
• Do not password-protect files on Adobe Security feature unless this password is also provided in the email
• When submitting multiple files for one request, passwords must be the same

Mailing

• Do not send paper correspondence; all documentation should be within the image files. Noridian suggests sending CD/DVD/USB via a tracked mailing service; however, it may be mailed by any method the provider chooses. See the Mailing Addresses page for state specific Certified/Courier mailings address details.
• We recommend providers follow these additional safeguards:
  • Label or indicate "restricted and/or confidential" on CD/DVD/USB
  • Include contact name and phone number/email
  • Maintain record of shipment so if package is lost, its contents can be recreated

To ensure timeliness standards are met, follow all information outlined above. Not doing so will result in the CD, DVD, or USB being returned.

esMD

• Noridian accepts Appeals, ADR responses and Prior Authorizations via the esMD mechanism. For information on this project, see the esMD webpage.
  • Ensure each submission contains the ICN for the claim being submitted.

NMP

• In addition to several inquiry functions, the Noridian Medicare Portal can be used for submission of Appeals, ADR responses, Prior Authorizations, and Reopenings.
• See the NMP User Manual for details.